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Chronic Stress & Chronic Illness: when neurodiverse marriage makes us sick. Part 2

Part 2 of 2

Guest Blogger: Abby

Now, imagine that one stressor multiplied by every other compounded scenario simultaneously occurring within the neurodiverse marriage. As much as an autistic spouse needs extra accommodation for regulating stress from overstimulation – it’s often overlooked that the neurotypical spouse is also running on sky-high cortisol.

Both spouses might agree that the patterns in their marriage are problematic. Yet, the dynamic may continue unabated, and the neurotypical spouse suffering from Ongoing Traumatic Relationship Syndrome eventually develops physical symptoms from the chronic emotional distress. 

Unrelenting stress and nervous system activation is intensely wearisome for the body. Chronic anxiety, hypervigilance, and a sense of perpetual crisis flood the body with adrenaline and cortisol. Continuous exposure to stress can lead to dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, which is crucial for keeping our body in homeostasis. When the HPA axis is disrupted, it impacts the body’s immune response, cardiovascular health, neuroendocrine and metabolic function, and the autonomic nervous system. 

Stress hormones reduce lymphocytes (our natural killer cells that go after invaders in our body), and inhibit antibody production. High cortisol produces pro-inflammatory cytokines. Immunoprotective cells are suppressed by inflammation, decreasing the ability to fight off viruses or infection.

Inflammation is intended by the body as a short-term solution to help initiate healing – such as when we injure a joint, and swelling occurs. Or, when invasive pathogens need to be eliminated quickly, and blood vessels respond by leaking fluid (creating inflammation), which helps contain the threat from spreading. But, when the body is confused by an ongoing threat signaled from unmitigated high cortisol, and unabated inflammation – the immune system attacks healthy tissue and organs. An autoimmune disease develops when the immune system is no longer able to distinguish healthy tissue from pathogenic threat. The body begins to attack itself. Autoimmune disease is significantly correlated with occurring after chronic stress. Anecdotally, many of my neurotypical clients suffer from a variety of autoimmune disorders, such as Hashimoto’s thyroiditis, rheumatoid arthritis, lupus, chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome, and Sjögren syndrome. 

High cortisol increases blood sugar, which over time creates insulin resistance and glucose intolerance. Appetite increases to support energy reserves for fight or flight. Weight gain from cortisol-induced metabolic dysfunction creates centralized, inflammatory fat. As weight accumulates in the abdomen, visceral fat wraps around organs – releasing inflammatory properties, and quickening the development of disease. High blood sugar leads to excess glucose that is unused by the body, and this extra glucose contributes to risk of developing diabetes, along with high triglycerides that impact cardiovascular health. Indirectly, lifestyle habits that result from obesity also impact the propensity for heart disease. 

When adrenaline is high, heart rate increases, and blood pressure is raised – an adaptation intended to be helpful for surviving threats. Arteries narrow when blood pressure is elevated, increasing the risk of hypertension developing. Hypertension causes the heart to pump blood more forcefully, stressing arteries. Visceral fat developed from metabolic dysfunction may surround the heart, and its release of inflammatory substances quicken the buildup of plaque, leading to coronary heart disease, or stroke. Elevated cortisol levels also cause the heart to pump excess resources into muscles for survival response, which reduces blood flow to the heart, and increases risk for heart attack. 

Continuous threat perception changes the brain’s emotional processing, due to sending out perpetual alarm signals to the amygdala, and over-activating the hypothalamus. Depression and anxiety frequently develop, and a high percentage of my neurotypical clients are on a number of psychotropic medications. Many of them note that they did not require pharmaceutical intervention for any mental health concerns prior to the ongoing relationship trauma occurring in their marriage. 

When the amygdala and hypothalamus are continuously managing an onslaught of threats, the HPA axis is perpetually disrupted, which thwarts the nervous system from functioning as intended. The sympathetic system (danger management) operates in over-drive, suppressing the restoration that would otherwise occur from the parasympathetic system (responsible for rest, relaxation, digestion, and repair after stressful occurrences). This prevents the autonomic nervous system from operating “automatic” body processes, such as heart rate. Dysautonomia creates a multitude of uncomfortable symptoms, which are extremely common in my neurotypical clients. Rapid heart rate with palpitations, unstable blood pressure, orthostatic intolerance, dizziness and fainting, shortness of breath, nausea, insomnia from circadian rhythm disruption, crushing fatigue, and brain fog. Of all the chronic illnesses that my neurotypical clients tend to suffer from, cardiac dysautonomia is extremely prevalent. 

Clearly, the impact of Ongoing Traumatic Relationship Syndrome as a stress disorder is potentially very destructive to health and well-being. Aside from excessive stress hormones causing enough inflammation to malfunction multiple body systems, other degenerative illnesses are intrinsically linked. Chronic inflammatory diseases include many mentioned above – diabetes, heart disease, stroke, obesity, and various autoimmune diseases – but also dementia, and cancer. I’ve walked alongside several neurotypical clients who, after decades of a high-conflict neurodiverse marriage, find themselves facing a cancer diagnosis, or Alzheimer’s Disease. Is this because of their chronic stress from a neurodiverse marriage? One can’t know for sure, but chronic stress and the subsequent inflammation is absolutely linked, implicated, and clinically identified as influencing the development of cancer, and Alzheimer’s disease. What often seems to torment my most ill clients is the inescapable rumination of wondering – was their self-sacrifice worth it? Did the endless striving ever improve their quality of life, or did it ultimately just destroy their own health?

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